Total Testosterone Crash After Starting Arimidex?

This is a repost as my original post had a ton of math related conversion mistakes (tests were originally all in pmol and nmol) which made the whole thing not make much sense. The below text has now been corrected :slight_smile:

I’m one of those types who usually figures everything out. I have my own business where I earn money solving other people’s problems. However, I have a problem that I just can’t fix and it’s just making me confused as all hell. Maybe one of you can shed some light…

I’ll be 43 years old this coming February 2017. Discovered back in September 2014 that I had low test. Crappy sex drive, ED, and gyno which was being kept under control using Calcium D-Glucarate. Went to get my levels checked and this is what was found. I’m from Quebec so they use different units of measurement though I found some online calculators to convert everything into what the rest of the planet appears to use, namely ng/dl and pg/ml:

September 2014 - Baseline

Total Testosterone: 227.09 ng/dl which is too low
Estradiol: 13.27 pg/ml which is too low
T:E Ratio would be 17.11 which is low.
FSH: 3.09 (1.50-12.40)
LH: 5.23 (1.7-8.6)
Prolactin: 302.1 (86.0-324.0)

I finally jumped onto the TRT bandwagon in April 2016 with doctors from an anti-aging clinic that really, really had no idea what they were doing. I began using Androgel @ 7.5g daily and 25mg DHEA daily. Nothing. Bumped it up to 10g daily. Nothing. Then we moved to compounded cream @ 100mg daily. Nothing. Then I figured let’s try to go REALLY high to at least see if I get some sort of reaction. Bumped it up to 200mg daily. Still didn’t feel anything after several weeks. Bumped up DHEA to 50mg daily (we were testing DHEA-S levels and saw that I could safely take more). Nothing. Then I began to read about guys applying the cream to the scrotum so I tried it. After about 5 days my mild gyno started to flare up like crazy. I figured a bad reaction was better than no reaction at all so at least we’ve proven something. Sex drive was starting to pick up however as well as better erections. Went to get a new blood test and this is what we found:

September 2016 - 200mg compounded cream applied to the scrotum plus 50mg DHEA

Total Testosterone: 1232.85 ng/dl (target value is 800-1200)
Estradiol: 49.58 pg/ml (target value is 20-30)
T:E Ratio would be 24.87 which is still too low which means that E2 needs to be brought down quite a bit.
SHBG: 20.5 (normal range is 13.2-89.5)

I began taking 0.25mg Arimidex EOD. Gyno almost vanished, or at least about as non-existant as it’s ever been. One month later I went for another blood test:

October 2016 - 200mg compounded cream applied to the scrotum plus 0.25mg Arimidex EOD plus 50mg DHEA

Total Testosterone: 413.83 ng/dl (target value is 800-1200) (why did it crash this much??)
Estradiol tested as LESS THAN 73 nmol/L (they way they calculate things in Canada). Let’s assume, after converting to pg/ml, that it probably got down to around 16 pg/ml (target value is 20-30)

T:E ratio would be somewhere around 25 which would be good but now the testosterone levels are crap.

Stopped taking the Arimidex as I was off the chart low (and who knows how low it actually got). Within two weeks, gyno started coming back. Sex drive was still crap. Now back on Arimidex E3D. Got an appointment to see a TRT friendly Endo next month. Trying to make some sense of all this:

  1. Testosterone value of 1232 ng/dl in September 2016 was either correct or a mistake
  2. Testosterone value of 413 ng/dl a month later after adding Arimidex was either correct or a mistake
  3. Read that taking Arimidex can affect readings of Total Testosterone, possible?
  4. Is it actually possible for my testosterone values to crash that much in 30 days??
  5. What do I do now?

Guys, please, all the ‘experts’ in the field that I’ve seen in person in my area have been absolutely useless. I need an idea to be pointed in the right direction. Thoughts?

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I’m no expert, but arimidex would only increase your testosterone (besides lower E2). And secondly, creams are incredibly inconsistent and is virtually impossible to measure how much you are actually getting into your system. I would switch to injections where you know with absolute certainty, how much you are putting inside your body. The reason your levels dropped are likely to do with the cream rather than the arimidex.

As far as your arimidex dosage to get to the correct E2 level, that again is difficult because your testosterone levels are all over the map.

In summary, arimidex isn’t causing your testosterone crash, but it is causing havoc with your E2 levels because your testosterone is not consistent enough to zero in on the proper arimidex dosage.

I would assume the same thing, though I’ve read multiple threads online with guys starting Arimidex only to see their Total Testosterone levels drop significantly, regardless of whether or not they are using creams or injections.

I wonder to what degree the inconsistency is with creams. Is it just a small variance from dose to dose or batch to batch, or can there be massive differences in dosing? Thing is, cream is applied daily and you don’t experience the highs and lows with injections if you’re only going to inject once a week (I couldn’t imagine doing it any more than once a week). Still, to go from the 1200’s to the 400’s within a month? Using the exact same product from the exact same compounding pharmacy?

I’m talking about consistency of absorption and uptake. You’re rubbing in 200mg a day, which is much as most people inject over a 2 week period. That shows you how poor the absorption is in general. So then, how much of that 200mg is getting absorbed on any given day? Not to mention everyone is different, and I’m sure everyone’s personal absorption rates vary daily too. With injections, the guesswork is left out of the equation.

As far as other people’s T totals crashing after starting arimidex, that’s new to me, but like I said, I’m no expert…

Personally, my total T went up and my free T skyrocketed when increasing my arimidex.

I guess I’ll wait and see what my next bloodwork test shows. I plan on doing one this coming week only with much more detail this time around. If levels are low I’ll switch to injectables.

btw, be sure to test for free testosterone as total levels are almost meaningless in comparison.

Yes, I’m realizing that the free hospital that I was going to was very limited in their testing. Found a private place where I can do Total Test, Free Test, Bioavailable Test, DHT, Prolactin, Progesterone, SHBG, etc. That’s going to decide how things will proceed from now on.

Did I point you to stickies before?

Transdermals are affected by thyroid, any labs to post?
Checked oral body temps as per the thyroid basics sticky?

Perhaps your skins ability to absorb T is affected by your E2 levels.

Anastrozole dose needs to match T levels which were to low.

Can you self-inject T and take skin variables out of the equation?
Would cost less.

Doing a much more extensive blood test this coming week including thyroid. Also have an appointment with a TRT friendly endo first week of February.

So, if I have thyroid issues it will affect transdermal absorbtion? Switching to injectables would eliminate this absorbtion issue?

I had no idea that low E2 can actually prevent proper absorbtion of transdermals. First I’ve heard.

My fiancé studied to be a nurse. She can do the injections for me.

So, is it possible that if I took TOO much arimidex, which lowered my E2 too much, that it could have affected the absorption of the transdermal, hence lowering my testosterone levels??

yes X 2

E2 and T trans skin abortion should not be an issue as that is a constant if E2 levels are maintained as suggested. But large deviations are an unknown and no certainty is implied.